Med Bull Sisli Etfal Hosp. 2021; 55(2): 210-216 | DOI: 10.14744/SEMB.2020.28000

Retinal Vascular Changes in Patients with Chronic Obstructive Pulmonary Disease: An Optical Coherence Tomography Angiography Study

Abdurrahman Alpaslan Alkan¹, Eyup Duzgun², Murat Karapapak², Mufide Arzu Ozkarafakili³, Ece Ozdemir Zeydanli⁴, Gurcan Dogukan Arslan⁵, Mehmet Egemen Karatas², Dilek Guven^2
1Department of Ophthalmology, Ercis Sehit Ridvan Cevik State Hospital, Van, Turkey
²Department of Ophthalmology, University of Health Sciences Turkey, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
³Department of Thoracic Diseases, University of Health Sciences Turkey, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
⁴Department of Ophthalmology, Ardahan State Hospital, Ardahan, Turkey
⁵Department of Ophthalmology, Tatvan State Hospital, Bitlis, Turkey

Objectives: In the current study, we aimed to investigate retinal vascular density and blood flow changes in patients with chronic obstructive pulmonary disease (COPD) using optical coherence tomography angiography (OCTA) (AngioVue Avanti, Optovue).
Methods: Thirty eyes of 30 patients with COPD and 30 eyes of 30 healthy controls were evaluated with OCTA. Foveal and parafoveal vessel density, inner retinal and choriocapillary flow area, and foveal avascular zone (FAZ) area were measured and compared between the groups.
Results: No statistically significant differences were observed in the outer retinal flow area and choriocapillary flow area measurements between the groups (p=0.609 and p=0.162, respectively). There was no statistically significant difference in FAZ and FAZ perimeter values between the groups (p=0.725 and p=0.820, respectively). Vascular density measurements in the superficial foveal and parafoveal areas were not statistically significantly different between the groups (p>0.05, for all). Deep parafoveal vascular density values of the COPD group were statistically significantly lower than the control group in all investigated areas except the superior and inferior quadrants.
Conclusion: The results of our study demonstrated for the first time that vascular density decreased in the parafoveal area due to COPD-related hypoxemia and endothelial dysfunction.

Keywords: Chronic obstructive pulmonary disease, deep capillary plexus, foveal avascular zone, optical coherence tomography angiography, superficial capillary plexus.

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Kronik Obstruktif Akciðer Hastalýðý Olan Hastalarda Retinal Vasküler Deðiþiklikler: Optik Koherens Tomografi Anjiografi Çalýþmasý

Abdurrahman Alpaslan Alkan¹, Eyup Duzgun², Murat Karapapak², Mufide Arzu Ozkarafakili³, Ece Ozdemir Zeydanli⁴, Gurcan Dogukan Arslan⁵, Mehmet Egemen Karatas², Dilek Guven^2
1Erciþ Þehit Rýdvan Çevik State Hospital, Department Of Ophthalmology, Van, Turkey
²University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Department of Ophthalmology, Istanbul, Turkey
³University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, Department of Thoracic Diseases, Istanbul, Turkey.
⁴Ardahan State Hospital, Department Of Ophthalmology, Ardahan, Turkey
⁵Tatvan State Hospital, Department Of Ophthalmology, Bitlis, Turkey

Amaç: Çalýþmamýz kapsamýnda Kronik Obstruktif Akciðer Hastalýðý (KOAH) olan hastalarda retinal vasküler dansite ve kan akýmý deðiþikliklerinin optik koherens tomografi anjiografi (OKTA) (AngioVue Avanti, Optovue) cihazý yardýmýyla araþtýrýlmasý amaçlanmýþtýr.
Gereç ve Yöntem: KOAH’ý olan 30 hastanýn 30 gözü ile 30 kiþilik saðlýklý kontrol grubunun 30 gözü OKTA yardýmýyla deðelendirilmiþtir. Foveal ve parafoveal vasküler dansite, iç retinal ve koryokapiller kan akýmý ve foveal avasküler zon (FAZ) alaný ölçülmüþ ve gruplar arasýnda kýyaslanmýþtýr.
Bulgular: Dýþ retinal kan akýmý ve koryokapiller kan akýmý arasýnda gruplar arasýnda istatistiksel anlamlý fark saptanmamýþtýr (p=0.609, p=0.162). FAZ ve FAZ perimetre deðerlerinde gruplar arasýnda istatistiksel anlamlý fark saptanmamýþtýr (p=0.725, p=0.820). Süperfisiyal foveal ve parafoveal alanlardaki vasküler dansite ölçümlerinde gruplar arasýnda istatistiksel anlamlý fark saptanmamýþtýr (p>0.05, hepsi için). Derin parafoveal vasküler dansite deðerlerinin, superior ve inferior kadran dýþýnda, incelenen tüm alanlarda KOAH grubunda kontrol grubuna göre istatistiksel anlamlý olarak daha düþük olduðu görülmüþtür.
Sonuç: Çalýþmamýzýn sonuçlarý KOAH iliþkili hipoksi ve endotelyal disfonksiyonun parafoveal alanda vasküler dansite kaybýna sebep olduðunu ilk defa ortaya koymuþtur. (SETB-2020-07-118)

Anahtar Kelimeler: Kronik Obstruktif Akciðer Hastalýðý, Optik Koherens Tomografi Anjiografi, Foveal Avasküler Zon, Süperfisiyal Kapiller Pleksus, Derin Kapiller Pleksus

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